摘要
目的系统评价血必净注射液辅助西医常规方法治疗重症社区获得性肺炎(SCAP)的有效性和安全性。方法计算机检索PubMed、EMBASE、Cochrane Library、CNKI、WANFANG DATA、VIP等数据库,检索时间为建库起至2020年3月,按照设定的纳入和排除标准筛选相关文献,采用风险偏倚评估工具对纳入随机对照试验(RCTs)的方法学质量进行评价,采用Review Manager 5.3分析软件对提取的数据进行meta分析。结果共纳入9篇文献,涉及共计1410例患者,其中试验组703例,对照组707例。Meta分析结果显示在西医常规治疗基础上使用血必净注射液辅助治疗SCAP相较于西医常规治疗能够提高总有效率[RR=1.29,95%CI(1.20,1.38),P<0.01],能够更好地降低白细胞计数[WMD=-3.30,95%CI(-3.69,-2.91),P<0.01],能够更好地降低C反应蛋白原水平[WMD=-4.45,95%CI(-8.16,-0.74),P=0.02],能够更好地降低综合评分APACHEⅡ[WMD=-0.97,95%CI(-1.32,-0.61),P<0.01],能够更好地降低机械通气时间[WMD=-87.36,95%CI(-173.91,-0.80),P=0.05],能够更好地降低ICU住院时间[WMD=-66.44,95%CI(-122.38,-10.51),P=0.02]。仅有3篇文献报道了不良反应的发生,结果显示西医常规治疗基础上使用血必净注射液辅助治疗SCAP可能发生包括皮肤瘙痒、头晕头痛、腹泻、上肢疼痛和过敏反应,发生率为1.6%。结论在西医综合治疗基础上辅助使用血必净注射液治疗SCAP能够提高临床疗效,降低ICU住院时间,改善生活质量。但鉴于本研究纳入文献的局限性,meta分析结果仅供临床应用参考。
Objective To systematically evaluate the efficacy and safety of Xuebijing injection as an adjuvant in the western routine treatment of severe community-acquired pneumonia(SCAP).Methods PubMed,EMBASE,Cochrane Library,CNKI,Wanfang Data,VIP and other databases were searched by computer.The retrieval time was from the establishment of the database to March 2020.According to the set inclusion and exclusion criteria,relevant literature were screened.The methodological quality of the included RCTs was evaluated by the risk bias assessment tool,and the Metadata analysis was performed on the extracted data using Review Manager 5.3 analysis software.Results A total of 9 articles were included,involving a total of 1410 patients,including 703 in experimental group and 707 in control group.Meta analysis showed that compared with the western routine treatment of SCAP,the application of Xuebijing injection as an adjuvant treatment on the basis of western routine medicine treatment improved the total effective rate(RR=1.29,95%CI[1.20,1.38],P<0.01),reduced the leukocyte count(WMD=-3.30,95%CI[-3.69,-2.91],P<0.01),decrease the level of C-reactive protein(WMD=-4.45,95%CI[-8.16,-0.74],P=0.002),lowered the comprehensive score APACHEⅡ(WMD=-0.97,95%CI[-1.32,-0.61],P<0.01),lessened mechanical ventilation time(WMD=-87.36,95%CI[-173.91,-0.80],P=0.05),cut down ICU hospitalization time(WMD=-66.44,95%CI[-122.38,-10.51],P=0.02).Only 3 articles reported the occurrence of adverse reactions.The results showed that the treatment of SCAP with Xuebijing injection on the basis of the western routine treatment may occur including skin itching,dizziness and headache,diarrhea,upper extremity pain and allergic reactions,with the incidence of 1.6%.Conclusion Treating SCAP with Xuebijing injection can improve the clinical effect,reduce the ICU hospitalization time and improve the quality of life.However,due to the limitations of the included literature in this study,the results of meta-analysis are only for clinical reference.
作者
孙忠华
徐驰
王越
刘丽洁
李棒棒
刘学娟
Sun Zhonghua;Xu Chi;Wang Yue;Liu Lijie;Li Bangbang;Liu Xuejuan(Intravenous Drug Dispensing Center, Affiliated Hospital of Qingdao University, Qingdao 266003, China)
出处
《临床荟萃》
CAS
2020年第10期869-875,共7页
Clinical Focus
作者简介
通讯作者:刘学娟,Email:347047810@qq.com。
